The objective of the research was to explore the relation between the incidences of erratic and community acquired legionnaires’ diseases and exposure to potentially infected industrial aerosols.
The originality of the study was not questionable. The research was original although some of the information concerning the notification was obtained from secondary sources. This information could have been obtained for other purposes although it was not used before for the same reason.
The design of the study was appropriate since the place it was set up matched with the objectives of the study. It involved an ecological study where it seeks to estimate risks from the data aggregated on a geographical basis. Also the residential codes set to represent the postcode were appropriate since they showed codes which could be used for statistical analysis.
The research studied the patients who had been diagnosed with the disease resulting from infections of industrial discharges that contaminate water as well as the industries in the stated areas. Patients who had been discharged for a week earlier were taken to have been sick with the infections. In the exposed postcodes the population was 20344 and 6838 in the unexposed postcodes. The study was conducted to both rural and urban areas. The number of case in the exposed postcodes was 204 while that of the unexposed was 167.
The assessment of the study was not blind since it had selected specific individuals who were to be included in the sample size. The industries to be examined were also specific, this could have caused bias because the all the subjects were not given equal chances of been included in the sample size. In the sample selection 3134 postcodes in the 42 French departments representing 53% of the entire French metropolitan population were taken and included in the analysis. 371 sporadic cases of community acquired legionnaires’ were identified. Secondary data was used and the source of the information the systems in France where the surveillance of legionnaires disease had been established. This information was based on clinicians’ notifications. The cases considered were the ones which had been reported to the local health officers who notified the national health authorities. The data collected was between 1998 and 2000 by the national notification system. The inventory of the industries sites that may have been involved in generating potentially contaminated water was compiled in 2001.
The outcome and the exposure measurements were appropriately described. The data for exposure to aerosols and plume of smoke were available for 42 French departments which was 44%. 1135 sources of exposure were identified which included 1015 sources of aerosols and 120 plume smoke sources.
The outcome in terms of gender was 671 men and 205 women; with average age at 57.4. Women were statistically older at 61.2 as compared to men at 56.3.The ethical issues in the report were addressed. It considered people from both the rural and the urban areas hence showing no discrimination. Factors affecting community were addressed. Statistical approaches were described where a poison regression model was to be used and bias was minimized. The presentation of the results was detailed since it made use of a table as well as some description. The discussion included the results in the context. The results obtained were used to discuss the findings of the research
